Credentialing Management

You open a new practice, bring on a new associate or you are adding carriers to your current portfolio of insurance carriers. If only it was as easy as saying “In-Network”!

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The task of credentialing is an arduous task and requires hours of collecting documents and completing new forms which you are likely asking your office manager to perform. In these hours, the office manager could be learning new software, training new team members or greeting new patients.

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The credentialing process requires precision and attention to detail.​  To perform this service, ACG has partnered with experts that offer decades of experience handling credentialing management with a wide variety of carriers.

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Our team has developed an on-boarding process in which we verify participation status, manage the process of gathering all the relevant documents, obtain and complete all the carrier forms and follow up to ensure the completion of the credentialing process.

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We use the following steps to ensure timely and accurate processing of your credentialing process:

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Verification

The first step in the credentialing process is to confirm which providers are at which locations and their participation status within the networks. Our team works closely with the insurance carrier networks to verify this information.

Provider Management

We will work closely with your designated representative(s) to secure the roster and on-boarding materials for each provider. Upon receipt of the on-boarding questionnaire and supplemental documentation, we review it to ensure that ALL information has been provided and then proceed to prepare the carrier specific credentialing documentation.

Carrier Management

Our partner has developed strong relationships with the insurance companies. These relationships enable us to make sure that the credentialing process is running smoothly from the carrier side of the equation. The carrier representatives enjoy working with our team due to their extensive knowledge of the credentialing process and their ability to effectively manage the credentialing process.

Follow Up

One of the most important components to the credentialing process is the follow up to ensure that effective dates have been met and that every provider that is being credentialed is successfully in-network with their desired carrier networks. Our partner's proprietary software allows for structured and timely follow up.

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IMPORTANT NOTE:  As strong as our team is in handling this process, depending on the particular insurance carrier, the process can take 60 – 90+ days to complete. Please plan accordingly!

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Request a free consultation to see how this service will benefit your practice!!

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